Racial, ethnic, and sex-based disparities among high-risk individuals undergoing pancreatic cancer surveillance.

Authors

Kelsey Klute

Kelsey Klute

University of Nebraska Medical Center, Omaha, NE;

Kelsey Klute , Aimee L. Lucas , Randall Brand , Jessica N. Everett , James J. Farrell , Kieran Hawthorne , Vivek Kaul , Sonia S. Kupfer , Salvatore Paiella , Diane M. Simeone , Daniel A. Sussman , George Zogopoulos , Fay Kastrinos , Bryson W Katona

Organizations

University of Nebraska Medical Center, Omaha, NE; , Icahn School of Medicine at Mount Sinai, New York, NY; , University of Pittsburgh, Pittsburgh, PA; , NYU Langone Health- Perlmutter Cancer Center, New York, NY; , Yale School of Medicine, Yale University, New Haven, CT; , Arbor Research Collaborative for Health, Ann Arbor, MI; , Division of Gastroenterology, Department of Medicine, University of Rochester Medical Center, Rochester, NY; , University of Chicago, Chicago, IL; , General and Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Verona, Italy; , University of Miami, Miami, FL; , McGill University Health Centre, Montreal, QC, Canada; , Columbia University Medical Center, New York, NY; , University of Pennsylvania Perelman School of Medicine (Philadelphia, PA), Philadelphia, PA;

Research Funding

Other
Project Purple, Ambry Genetics, Invicro

Background: The international, multi-center Pancreatic Cancer Early Detection (PRECEDE) Consortium enrolls high-risk individuals (HRIs) undergoing pancreatic ductal adenocarcinoma (PDAC) surveillance. Enrollment began in 2020, and despite challenges related to the COVID-19 pandemic, the PRECEDE Consortium rapidly accrued a large cohort of HRIs. The purpose of this study is to describe the characteristics of this cohort and assess racial, ethnic, and sex-based disparities. Methods: The PRECEDE Consortium (NCT04970056) is a prospective, multicenter study focused on improving survival from PDAC through early detection. Data from all HRIs who met criteria for PDAC surveillance and enrolled between May 2020 - March 2022 were collected and included in the analysis. Results: During the study period, 1299 HRIs enrolled in PRECEDE at 32 centers. HRIs were excluded if enrollment data was incomplete or criteria for PDAC surveillance were not met. Of 1113 who were included, 47.2% met criteria for familial pancreatic cancer (FPC) and 45.4% had a family history of PDAC along with a PV in a PDAC-risk gene (BRCA1, BRCA2, PALB2, ATM, MLH1, MSH2, MSH6, PMS2, or EPCAM). The remainder had familial atypical mole melanoma syndrome (5.7%), Peutz-Jeghers syndrome (1.6%), or hereditary pancreatitis (0.2%). More females than males enrolled (65.9% vs. 33.5%). The distribution of HRIs by race and ethnicity is depicted; the majority identified as white (87.7%). Study participants were primarily from the US (82.7%), the median age was 61 (27-85) and 18.5% had Ashkenazi Jewish ancestry. Nearly all HRIs consented to allow access to imaging data (99.6%), collection of germline DNA (97.7%), and biosample collection (99.5%). There were no race, ethnicity, or sex-based differences in rates of consent for collection of imaging, DNA, or biosamples. Conclusions: Enrollment of HRIs in prospective studies of PDAC surveillance is essential for advancing early detection research in PDAC. A distinct advantage of the PRECEDE Consortium for examining enrollment disparities is that recruitment began in 2020, providing a unique and current snapshot of the international PDAC surveillance landscape. Despite the recent attention on addressing disparities in healthcare delivery, significant racial, ethnic, and sex-based disparities persisted in the cohort of HRIs enrolled in the PRECEDE Consortium. Ensuring that the diversity of participants in the PRECEDE Consortium mirrors the communities served by participating centers is crucial. Further examining and addressing the reasons for these disparities is a major focus of the PRECEDE Consortium moving forward.

Race and ethnicity of HRIs enrolled in the PRECEDE Consortium.


Variable
N = 1113%
RaceWhite97687.7%
Black222%
Asian70.6%
Other676%
Multiracial90.8%
Unknown322.9%
EthnicityNon-Hispanic105094.3%
Hispanic322.9%
Unknown322.8%

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Abstract Details

Meeting

2023 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session B: Cancers of the Pancreas, Small Bowel, and Hepatobiliary Tract

Track

Pancreatic Cancer,Hepatobiliary Cancer,Neuroendocrine/Carcinoid,Small Bowel Cancer

Sub Track

Prevention, Screening, and Hereditary Cancers

Citation

J Clin Oncol 41, 2023 (suppl 4; abstr 687)

DOI

10.1200/JCO.2023.41.4_suppl.687

Abstract #

687

Poster Bd #

J12

Abstract Disclosures